Panic attacks, panic disorder, and agoraphobia: Associations with substance use, abuse, and dependence
Abstract
Anxiety and substance use disorders frequently co-occur. Despite the clinical importance of this co-occurrence, theory and research addressing the relations between anxiety-substance use disorder comorbidity remain limited. The present commentary is intended to briefly review and summarize key aspects of this literature, with a specific focus on panic-spectrum psychopathology (panic attacks, panic disorder, and agoraphobia) and its associations with tobacco, alcohol, and marijuana use, abuse, and dependence. A heuristic theoretical model for better understanding the panic-substance use relations also is offered. Extant data suggest clinically meaningful bidirectional associations are evident between panic problems and premorbid risk factors for such problems and various forms of tobacco, alcohol, and marijuana use. Key clinical implications and future directions are outlined based upon the review.
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There is a relationship between anxiety disorders such as PD and strikingly high rates of comorbidity and prospective onset of alcohol and tobacco use disorders among these individuals.
“This seems notable, given the relationship between anxiety disorders, such as PD, and the strikingly high rates of comorbidity and prospective onset of alcohol and tobacco use disorders among these individuals (Zimmermann et al., 2003; Zvolensky, Bernstein, Marshall, & Feldner, 2006).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Zvolensky, Bernstein, Marshall, & Feldner, 2006
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La percepción de control de la ansiedad en el trastorno límite de la personalidad
Clausell, M. R., Haro, M. V. N., López, J. J. O., & García‐Palacios, A. (2017) · Àgora de salut · doi:10.6035/agorasalut.2017.4.36 · Cited by 1 · see citing works
Adolescent co-occurring disorders
Reedy, A. R. (2010) · doi:10.17077/etd.ux973d4j
Vujanovic, A. A. (2008) · ScholarWorks -A service of University of Vermont Libraries (University of Vermont)
Bonn‐Miller, M. O. (2008) · ScholarWorks -A service of University of Vermont Libraries (University of Vermont)
Assessment of Substance Abuse and Dependence in Anxiety Disorders
Zvolensky, M. J., Kosiba, J. D., Grover, K. W., & Perrone, M. D. (2013) · Springer eBooks · doi:10.1007/978-1-4614-6452-5_7
Self-citationPanico: nosografia di un'entità, clinica di un disturbo
Mancuso, F., Marucco, D. A., Vivo, E. D., Bellinato, M., Desantis, G., Gramoni, A., Pini, D., Zeme, D., & Bignamini, E. (2017) · MISSION · doi:10.3280/mis48-2016oa4726
Conway, C. (2013) · eScholarship (California Digital Library)
van der Veen, L., & Beekhof, A. M. (2011) · Utrecht University Repository (Utrecht University)
(2011) · Wiley eBooks · doi:10.1002/9781118101056.refs
Motta, R. W. (2022) · IntechOpen eBooks · doi:10.5772/intechopen.102252
Orelogio, A. A., García-Esquirol, Ó., Rodriguez, M. E., Gausa, A. M., & Ramis, E. S. (2023) · medRxiv · doi:10.1101/2023.05.24.23290449
Kinney, K. L., Morris, M. C., Beesdo‐Baum, K., & Watts, A. L. (2026) · Clinical Psychological Science · doi:10.1177/21677026261443518
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- Authors
- Zvolensky, M. J., Bernstein, A., Marshall, E. C., & Feldner, M. T.
- Affiliations
- University of Vermont (US)
- Corresponding author
- Zvolensky, Michael J.
- Venue
- Current Psychiatry Reports
- Published
- 2006-07
- Volume
- 8
- Issue
- 4
- Pages
- 279-285
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- OpenAlex
- W1985818696
- Cited by
- 73
- References
- 51
- Citations by year
- 2026: 3 · 2025: 1 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 1 · 2018: 3 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 4 · 2013: 6 · 2012: 3
- FWCI
- 11.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5f31mh073205-02, 5r01da018734-03)
- National Institute of Mental Health (F31MH073205-01)
- National Institute on Drug Abuse (R03DA016307, 1R01 DA 018734-01A1, R03 DA16307-01, 1 R21 DA016277-01)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- panic attacks, panic disorder, agoraphobia, substance use disorders, substance abuse, substance dependence, tobacco use, alcohol consumption, cannabis use, bidirectional relationship, premorbid risk factors
- MeSH terms
- Agoraphobia, Humans, Panic Disorder, Substance-Related Disorders
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